A foot drop compensation device based on surface multi-field functional electrical stimulation—Usability study in a clinical environment

Abstract

IntroductionFunctional electrical stimulation applies electrical pulses to the peripheral nerves to artificially achieve a sensory/motor function. When applied for the compensation of foot drop it provides both assistive and therapeutic effects. Multi-field electrodes have shown great potential but may increase the complexity of these systems. Usability aspects should be checked to ensure their success in clinical environments.MethodsWe developed the Fesia Walk device, based on a surface multi-field electrode and an automatic calibration algorithm, and carried out a usability study to check the feasibility of integrating this device in therapeutic programs in clinical environments. The study included 4 therapists and 10 acquired brain injury subjects (8 stroke and 2 traumatic brain injury).ResultsTherapists and users were “very satisfied” with the device according to the Quebec User Evaluation of Satisfaction with Assistive Technology scale, with average scores of 4.1 and 4.2 out of 5, respectively. Therapists considered the Fesia Walk device as “excellent” according to the System Usability Scale with an average score of 85.6 out of 100.ConclusionsThis study showed us that it is feasible to include surface multi-field technology while keeping a device simple and intuitive for successful integration in common neurorehabilitation programs.

Usability of Functional Electrical Stimulation in Upper Limb Rehabilitation in Post-Stroke Patients: A Narrative Review

“…Satisfaction is the users’ comfort with and positive attitudes towards the use of a system [ 80 ]. The System Usability Scale [ 81 ] and Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire [ 81 , 82 ] were used to assess the usability and the related satisfaction of both the therapists and subjects for lower limb multifield technology. The results of these studies demonstrate that it is feasible to include surface multifield technology while keeping a device simple and intuitive for successful integration in common neurorehabilitation programs.…”

Enhancing Adaptations to Neuromuscular Electrical Stimulation Training Interventions

“…Accessible nerves in the lower limbs include the common peroneal and tibial, at the side and back of the knee, respectively. Indeed, NMES was first applied over the common peroneal nerve in the 1960s to dorsiflex the ankle during the swing phase of walking for individuals experiencing “foot drop” after a stroke ( 15 ), and this application is still in use today. Although the femoral nerve is accessible in the femoral triangle to activate the quadriceps, there are challenges (both physical and social) in accessing the site, and it is difficult to generate stable knee extensor contractions while minimizing discomfort; it is thus not feasible in many individuals.…”

“…Distributed NMES has been applied to different lower and upper limb muscles in healthy subjects and neurological patients and studied in a variety of conditions from static single-joint actions ( 21 ) to functional movements and activities of daily living ( 15 , 20 ). For example, “multipath” NMES — where pulsed current is delivered to the quadriceps muscle through a wearable solution integrating large electrodes and multiple current pathways — was more effective than conventional NMES for restoring muscle strength and physical function after knee surgery ( 4 ).…”

“…This may be explained by the higher contraction force, presumably through a greater and more distributed MU recruitment, achieved with multipath NMES than conventional NMES ( 24 ), but possibly also to lower discomfort and hence greater training compliance ( 4 , 24 ). Although the usability of a new foot drop NMES device based on surface multifield electrodes has recently been demonstrated in a clinical rehabilitation context ( 15 ), its therapeutic effects within a neurorehabilitation program remain to be confirmed. Regardless, with a careful selection of channel numbers, NMES frequency, and intensity, both neuromodulation effects and fatigue-resistant contractions could be attained.…”

Analysis of the movements generated by a multi‐field functional electrical stimulation device for upper extremity rehabilitation

“…However, multi‐field surface electrodes have emerged, consisting of clusters of several small conducting fields, which can be activated/deactivated and configured independently. These electrodes have shown a great potential on FES selectivity, muscle fatigue delay, and easier donning and doffing 10 . The muscular selectivity takes on a special relevance in the rehabilitation of the upper extremity, as hand dexterity requires a wide diversity of specific muscle actions 11 …”